Right phrenic injury after radiofrequency catheter ablation of atrial tachycardia at crista terminalis / 中华医学杂志(英文版)

A 62-year-old woman with frequent occurrence of symptomatic atrial tachycardia with a foci located at the root of the upper crista terminalis was found to have right diaphragm paresis after receiving a total of 8 radiofrequency energy deliveries (40-60 W, 50-60ºC) and a total duration of 540 seconds of ablation therapy (7Fr 8 mm deflectable ablation catheter). The right diaphragm paresis remained resolved up to 14 months after the procedure as confirmed by repeated chest X-rays.

QT hysteresis in long-QT syndrome children with exercise testing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Congenital long QT syndrome (LQTS) is an inherited ion channel disorder resulting in abnormal cardiac repolarization that can cause syncope and sudden death associated with a prolonged rate-corrected QT interval and polymorphic ventricular tachycardia. Several studies in adults showed that LQTS patients have altered QT adaptation to heart rate changes compared with normal subjects which forming a "hysteresis loop" in the QT-circle length plot. This study was to observe the QT interval changing during exercise testing in children long QT syndrome (LQTS) patients, explore the new diagnosis methods of LQTS.</p><p><b>METHODS</b>The subjects were divided into 3 groups according to 1993 LQTS diagnostic criteria. Group 1: LQTS group (n = 17) who scored > or = 4 points indicating definite LQTS. Group 2: Middle group (n = 16), patients who have prolonged QT interval but scored 1.5 to 3.5. Group 3: Normal control group (n = 18). The average age of all study population is (12.3 +/- 5.8) years. No case had beta-adrenergic antagonists administration before exercise testing. All subjects were underwent tread mill exercise testing and electrocardiograph in whole exercise testing and recovery were recorded. QT and heart rate changing during whole exercise testing period were recorded. DeltaQT, the QT interval at 1, 2, 4, 6 minutes into recovery subtract from the QT interval at a similar heart rate during exercise, were calculated.</p><p><b>RESULTS</b>In all three groups, QT intervals were shortening with the increasing of heart rate, but QTc had no significant change. DeltaQT at 1 minute ((45 +/- 11) ms), 2 minutes ((37 +/- 15) ms), 4 minutes ((23 +/- 12) ms) into recovery in LQTS group were significantly greater than that of the other two groups (P < 0.05, P < 0.01, P < 0.01, respectively). There was no DeltaQT significant difference between middle group and normal control group at recovery time. During the recovery phase in LQTS group, the QT interval remained shortened despite a decelerating heart rate, forming a hysteresis "loop" in the curve relating the QT interval to the cycle length.</p><p><b>CONCLUSIONS</b>In children LQTS patients, there is significant QT hysteresis loop in the relation of QT interval with heart rate during recovery of exercise testing, which could be useful to the early diagnosis for LQTS.</p>

Effect of Astragalus injection on plasma levels of apoptosis-related factors in aged patients with chronic heart failure / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of Astragalus injection (AI) on plasma levels of apoptosis-related factors in aged patients with chronic heart failure (CHF).</p><p><b>METHODS</b>Seventy-two CHF patients were randomly divided into the AI group (36 cases) treated with AI and the control group (36 cases) treated with conventional treatment. Plasma levels of soluble Fas (sFas), soluble Fas ligand (sFasL), tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assays (ELISA) with monoclonal anti-human antibodies. Besides, New York Heart Association (NYHA) grading was assessed according to improved symptoms and left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were assessed by echocardiogram after 4 weeks of treatment.</p><p><b>RESULTS</b>After 4 weeks of treatment, NYHA grading was markedly improved in the two groups, but it was significantly better in AI group than that in the control group (P < 0.05). As compared with the control group, sFas, sFasL, TNF-alpha and IL-6 in the AI group were obviously lower, the difference between the two groups and between before and after treatment were significant (P < 0.05 or P < 0.01). Moreover, in AI group, LVESV and LVEDV decreased, LVEF increased, which was significantly different than that before treatment (P < 0.05), respectively.</p><p><b>CONCLUSION</b>AI could lower plasma levels of apoptosis-related factors, and is one of the effective drugs in improving cardiac function in the aged patients with CHF.</p>

Dual chamber pacing for vasovagal syncope / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effect of DDD pacing on vasovagal syncope (VVS).</p><p><b>METHODS</b>Eleven patients diagnosed VVS (7 with heart inhibiton type, 4 with combination type)by tilt table test (TTT) in Shanghai Chest Hospital were selected into the study. They all were implanted DDD pacemaker in whom 9 with rate-drop response (RDR) function. All of them were prescribed beta-receptor blocker. The patients were followed-up at 1, 3, 6, 12, 24 months after being discharged.</p><p><b>RESULTS</b>All the 11 patients with pacemaker implantation were free from syncope, in whom 4 still had pre-syncope discomfort, but the symptoms were slightly. Six patients took TTT again after pacemaker implantation. It was observed that pacing at an elevated rate started immediately when heart rate dropping to the lower threshold, and as a result syncope were prevented.</p><p><b>CONCLUSION</b>In the VVS patients with recurrent syncope and severe heart inhibition, DDD pacing with RDR function could prevent from syncope efficiently.</p>

Clinical study on effect of Astragalus injection on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Astragalus injection (AI) on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>AMI patients were randomly divided into the AI group (54 cases) treated with AI and the control group (54 cases) treated with conventional treatment. Left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), anterior endocardial segmental length (ASL), posterior endocardial segmental length (PSL) were assessed by echocardiogram at the 1st and the 4th week of treatment; and the cardiac systolic and diastolic functions were detected by nuclide gating cardiac blood pool imaging on the 4th week. Besides, the plasmic levels of lipid peroxide (MDA), count of endothelial cell (CEC) and superoxide dismutase (SOD) were determined before and after treatment.</p><p><b>RESULTS</b>At the 4th week, changes of LVEDVI, LVESVI and ASL in the AI group were not obvious, but increased significantly in the control group, the significant difference in comparison between the two groups was shown (P < 0.05). As compared with the control group, in the AI group, the left ventricular ejection fraction, left ventricular peak ejecting rate and left ventricular peak filling rate were higher, and the left ventricular time for peak filling rate was shorter, moreover, MDA and CEC were lower and SOD was higher. The difference between groups and between before and after treatment were significant (P < 0.01 or P < 0.05).</p><p><b>CONCLUSION</b>AI is one of the effective drugs in reversal of left ventricular remodeling and improving left ventricular function in patients with AMI.</p>